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Generic Criteria – Summary Personality Disorders
California State University, Los Angeles, US has reference to this Academic Journal, Personality Disorders EPC 695B All humans have personality traits. These are well-ingrained ways in which individuals experience, interact with, in addition to think about everything that goes on around them. Personality Disorders are collections of traits that have become rigid, in addition to work so that individual?s disadvantage, so that the point that their personality disorders impair functioning or cause distress.
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All of the DSM-IV-TR personality disorders are patterns of behavior in addition to thinking that have been present since early adult life in addition to have been recognizable in the client in consideration of a long time.Personality disorders are probably dimensional, not categorical This means that their components (the traits) are present in normal people, but are accentuated in those alongside the disorders in question. ÿ A lasting pattern of inner experience in addition to behavior that markedly deviates from norms of the client’s culture. The pattern is manifested in at least two of these areas: a. Cognition (how the client perceives in addition to interprets self, others, in addition to events) b. Affect (appropriateness, intensity, lability, in addition to range of emotions) c. Interpersonal functioning d. Impulse control Generic Criteria in consideration of Personality Disorders (p. 689) ÿ
This pattern is fixed in addition to affects many personal in addition to social situations.The pattern causes clinically important distress or impairs work, social, or personal functioningThis pattern has lasted a long time, alongside roots in adolescence or young adulthood.The pattern is not better explained by another mental disorder.The pattern is not directly caused by a GMC or by the use of substances, including medication.Generic Criteria in consideration of Personality Disorders (con?t.) These general criteria are extremely important. They identify vital points that are central so that the diagnosis of any personality disorder. To summarize, a personality disorder is:Lifelong, Affects many areas of the client’s life, Causes problems, in addition to Is not the product of another illness. ÿGeneric Criteria – SummaryLet?s look together at the handout: Morrison?s Quick Guide so that the Personality Disorders
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See additional handouts:Diagnosing Personality DisordersPersonality DisordersDiagnosing Personality DisordersTo make a specific diagnosis – a semi-structured interview can be used, augmented by a self-report personality inventory. a. Semi-structured interviews guide the therapist through a series of questions that assess all of the potential personality disorders. Example: SCIS-II by Spitzer, Williams & Giffon (Helps so that avoid impressions that rely on only one or two symptoms rather than the full criteria set.) b. Millon Clinical Multiaxial Inventory II (MCMI-I) is a self- report measure. Self report inventories tend so that indicate more personality disorder pathology than reported by clinical interviews. Thus, the inventories are only suggestive of possible diagnoses in addition to alternatives.Assessment of Personality Disorders Personality disorders are more vulnerable so that error of diagnosis than Axis I disorders. Diagnostic errors occur most often when the therapist fails so that adhere so that the diagnostic criteria or when the therapist has a gender or cultural bias. For example: The counselor may only see one key symptom in addition to make or rule out a diagnosis without carefully looking in consideration of the entire cluster of symptoms required so that meet DSM criteria. Assessment of Personality Disorders (con?t.)
For example: A study by Morey in addition to Ochoa (1989) found that, when a client alongside a borderline personality disorder had a symptom of little sexual interest, the client was not diagnosed correctly because clinicians believe that clients alongside borderline personality disorder are sexually promiscuous. Assessment of Personality Disorders (con?t.)A study by Ford in addition to Widiger (1989) also found that failure so that adhere so that criteria made it more likely that the clinician would be influenced by gender in addition to cultural background of client. For example, clinicians making diagnoses of histrionic in addition to antisocial personality disorder were affected in their diagnoses by the sex of the client (women seen as histrionic, men as antisocial), but when asked so that assess, using given criterion symptoms, they were not biased by client sex. Assessment of Personality Disorders (con?t.) 1. If a client has an Axis I diagnosis, but a personality disorder is the main reason the client has come in consideration of evaluation, (Principal Diagnosis) should be attached so that the Axis II diagnosis. Axis I ÿ312.32 Kleptomania Axis II 301.6 Dependent Personality Disorder (Principal Diagnosis) 2. A frequently used defense mechanism can be indicated on the Axis II line: Axis II 301.0 Paranoid Personality Disorder; frequent use of projectionSee DSM-IV-TR, p. 811: Defense Mechanism in addition to Coping StylesCoding Notes
ÿ3. If your client’s personality disorder preceded a psychotic disorder (most often Schizophrenia), the diagnosis might read:Axis I 295.10 Schizophrenia, Disorganized Type, Continuous, With Prominent Negative SymptomsAxis II 301.22 Schizoid Personality Disorder (Premorbid)Coding Notes (con?t.)Please look at handout: Correlation between Axis II Personality Disorders in addition to Axis I Mental DisordersNow look at: Profile of Characteristics of Personality Disorders in your packet
a. Central characteristic: unjustified distrust in addition to suspicion of others.Because the client fears exploitation, s/he will not confide in others ? even those who have earned his/her trust. c. Client reads unintended meaning into benign comments in addition to actions. d. Client will interpret specious occurrences as the result of deliberate intent in addition to will harbor resentment in consideration of a long time, perhaps forever. e. These clients are rigid, often litigious, in addition to have an especially urgent need so that be self-sufficient.301.0 Paranoid Personality Disorderf. To others, these clients appear so that be cold, calculating, in addition to guarded people who avoid both blame in addition to intimacy.g. When interviewed, they may appear tense in addition to have trouble relaxing.h. This disorder is especially likely so that create occupational difficulties; these clients are so aware of rank in addition to power that they frequently have trouble dealing alongside superiors in addition to co-workers.i. Although it is far from rare (about 1% of the general population), it rarely comes so that clinical attention. Usually diagnosed in men. Its relationship (if any) so that the development of Schizophrenia, Paranoid Type, remains unclear.301.0 Paranoid Personality DisorderTreatment OptionsSupportive psychotherapy, Confronting beliefs about therapist,Pharmacotherapy, Behavioral TherapyCountertransference Anger, Withholding negative feedback Case: Useful Work (DSM-IV-TR Casebook, p. 211)301.0 Paranoid Personality Disorder
Indifferent so that the society of other peopleLifelong loners, who show a restricted emotional range; they appear unsociable, cold in addition to seclusiveUnusually succeed at solitary jobs others find difficult so that tolerateMay daydream excessively, become attached so that animals, in addition to often do not marry or even have long-lasting romantic relationshipsDo retain contact alongside realityDisorder is relatively common, affecting perhaps a few percent of the general populationMen are at greater risk than women.301.20 Schizoid Personality DisorderTreatment OptionsSupportive TherapyPharmacotherapyCognitive reorientation therapyGroup TherapyCountertransference: As watch film, see what feelings he engenders in you.Film: Jerry – Schizoid Personality Disorder 301.2 Schizoid Personality DisorderFrom early age have lasting interpersonal deficiencies that severely reduce capacity in consideration of closeness alongside others.Also has distorted or eccentric thinking, perceptions, in addition to behaviors that can make these clients seem odd. Often feel anxious when alongside strangers in addition to have almost no close friends.d. May be suspicious in addition to superstitiousPeculiarities of thought include magical thinking in addition to belief in telepathy or other unusual modes of communication.May talk about sensing a “force” or “presence,” or have speech characterized by vagueness, digressions, excessive abstractions, impoverished vocabulary, or unusual use of words.301.22 Schizotypal Personality Disorder
g. May eventually develop Schizophrenia.h. Many are depressed when first come so that clinical attention.Eccentric ideas in addition to style of thinking also place these clients at risk in consideration of becoming involved alongside cults.Gets along poorly alongside others and, under stress, may briefly become psychotic.Many marry in addition to work.Occurs as often as Schizoid Personality Disorder301.22 Schizotypal Personality DisorderOverlapping Diagnoses: Axis I: Paranoid Schizophrenia; Mood Disorder; Obsessive-Compulsive Axis II: Borderline; SchizoidÿTreatment Options PharmacologicalSupportive TherapyCounter-transference Underestimating importance of treatment so that client. Why would that happen?ÿCase: Wash Before Wearing (DSM-IV Casebook, p. 289)ÿ301.22 Schizotypal Personality DisorderChronically disregard in addition to violate rights of other people; these individuals cannot or will not conform so that the norms of society.Some are engaging con-artists; others may be graceless thugs.Women are often prostitutes.Seem superficially charming, but are aggressive in addition to irritable.This personality disorder affects nearly every life area: In addition so that substance use, there may be fighting, lying, in addition to criminal behavior of every conceivable sort: theft, violence, confidence schemes, in addition to child in addition to spouse abuse. Claim so that have guilt feelings, but do not appear so that feel genuine remorse in consideration of this behavior.301.7 Antisocial Personality Disorder
Claim so that have guilt feelings, but do not appear so that feel genuine remorse in consideration of this behavior. Manipulative interactions alongside others make it difficult so that decide whether or not complaints are genuine.About 3% of men, but only 1% of women have this disorder.Accounts in consideration of 3 out of every 4 penitentiary prisoners.More common among lower class populations in addition to runs in families; probably both genetic in addition to environmental.Disorder decreases possibly alongside increasing age. Individual mellows out after 30; however, still are substance users.Death by suicide or homicide is sometimes their lot. Can’t get this diagnosis if antisocial behavior occurs only in the context of substance abuse. Crucial so that learn whether clients have engaged in illicit acts when not using substances.Only one-half of children alongside anti-social background eventually develop the full adult syndrome.ÿ301.7 Antisocial Personality DisorderOverlapping Diagnoses Axis I Major Depression; Substance abuse Axis II Borderline; NarcissisticTreatment Options: Morrison: No known effective treatment Others have said: Pharmacotherapy; Marital/Family;Behavioral (i.e., token economies, assertiveness training; education); Cognitive Therapy Countertransference: Watch your feelings when you see the film. Gullibility SuspiciousnessFilm: Antisocial Personality Disorder (Tape 3) George #8ÿ301.7 Antisocial Personality DisorderThis concept was devised about the middle of the 20th century. Clients were originally (and sometimes still are) said so that be on the borderline between neurosis in addition to psychosis. The existence of this disorder is disputed by many clinicians. As the concept has evolved into a personality disorder, it has achieved remarkable popularity, perhaps because so many clients can be shoe-horned into its definition.About 1-2% of general populations may legitimately qualify in consideration of this diagnosis.These clients have a pattern of instability throughout adult live.The most over-used diagnosis in the DSM-IV. Many of these clients really have Axis I disorders that are more readily treatable, such as Major Depressive Disorder, Somatization Disorder, in addition to Substance-related Disorders.Often appear in crisis of mood, behavior, or interpersonal relationships.301.83 Borderline Personality Disorder
Used in consideration of clients who have insufficient features in consideration of a better-defined personality disorder, but who appears so that have long-standing personality traits that have cause difficulties in many life areas.Can also be used in consideration of other personality disorders that have not yet received official DSM sanction.Many individuals have long-standing personality traits, but these traits cut across several personality disorders in addition to they don?t completely meet the criteria in consideration of any one of them.Case: Stubborn Psychiatrist (DSM-IV Case book, p. 166)301.9 Personality Disorder NOS
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This Particular Journal got reviewed and rated by g. May eventually develop Schizophrenia.h. Many are depressed when first come so that clinical attention.Eccentric ideas in addition to style of thinking also place these clients at risk in consideration of becoming involved alongside cults.Gets along poorly alongside others and, under stress, may briefly become psychotic.Many marry in addition to work.Occurs as often as Schizoid Personality Disorder301.22 Schizotypal Personality DisorderOverlapping Diagnoses: Axis I: Paranoid Schizophrenia; Mood Disorder; Obsessive-Compulsive Axis II: Borderline; SchizoidÿTreatment Options PharmacologicalSupportive TherapyCounter-transference Underestimating importance of treatment so that client. Why would that happen?ÿCase: Wash Before Wearing (DSM-IV Casebook, p. 289)ÿ301.22 Schizotypal Personality DisorderChronically disregard in addition to violate rights of other people; these individuals cannot or will not conform so that the norms of society.Some are engaging con-artists; others may be graceless thugs.Women are often prostitutes.Seem superficially charming, but are aggressive in addition to irritable.This personality disorder affects nearly every life area: In addition so that substance use, there may be fighting, lying, in addition to criminal behavior of every conceivable sort: theft, violence, confidence schemes, in addition to child in addition to spouse abuse. Claim so that have guilt feelings, but do not appear so that feel genuine remorse in consideration of this behavior.301.7 Antisocial Personality Disorder and short form of this particular Institution is US and gave this Journal an Excellent Rating.